Renal dosing common medications

Posted by dkwinter

Drug	Usual dose	Renal dosing
Amoxicillin	500-1000 mg PO TID	EGFR >30: no change EGFR 10-30: 250-500 mg PO q12h EGFR <10: 250-500 mg PO q12-24h HD: 250-500 mg po q12-24h PD: 250-500 mg po q12h
Amoxicillin/Clavulanate	500/125 mg PO q8h OR 875/125 mg PO q12h	Same as amoxicillin
Cephalexin (Keflex)	250-500 mg PO QID	EGFR >30: no change EGFR 15-30: 250-500 mg PO q8-12h EGFR <15: 250-500 mg PO q12-24h
Ceftriaxone (Rocephin)	1-2 g IV q24h	EGFR >15: no change EGFR <15: no change
Cefuroxime (Ceftin)	500 mg PO q12h	EGFR >30: no change EGFR 10-30: 250 mg PO q12h EGFR <10: 250 mg PO q24h
Ciprofloxacin	500-750 mg PO q12h	EGFR >50: no change EGFR 30-50: 250-500 mg PO q12h EGFR <30: 500 mg PO q24h Dialysis: 250-500 mg PO q24h
Nitrofurantoin (Macrobid)	100 mg PO q12h	EGFR >45: no change EGFR 30-45: no change, may use with caution for short courses
Trimethaprim-sulfamethoxazole (Bactrim, Septra, Sulfatrim)	160/800 (DS) mg PO q12h	EGFR >30: no change EGFR 15-30: take 1 DS dose PO once then 1 SS dose PO q12h EGFR <15: take 1 SS dose PO once then 1 SS dose PO q24h